Cultural Awareness - 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

Cultural Awareness

• Interacts effectively with people from different cultural backgrounds.
• Encourages a work environment where individual differences are valued.
• Functions effectively within various cultural contexts.
• Participates in cultural training sessions/classes.
• Communicates with others without the influence of racism.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Problem Solving

• Makes judgments based upon relevant information.
• Able to balance the needs of different people in a solution to a problem.
• Finds creative ways to get things done with limited resources.
• Is a good problem solver and decision maker
• Identifies fresh approaches and shows a willingness to question traditional assumptions.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Technical

• Demonstrates mastery of the technical competencies required in his/her work.
• Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
• Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
• Seeks information from others as needed.
• Knows how to produce high quality products/work.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Objectives

• Establishes goals and objectives.
• Communicates goals and objectives to employees.
• Organizes and schedules events, activities, and resources.
• Able to organize work.
• Encourages me to take on greater responsibility.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Trustworthy

• Works in a way that makes others want to work with her/him.
• Takes care to maintain confidential information.
• Demonstrates congruence between statements and actions.
• Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
• Is a person you can trust.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.